GLUCOCORTICOID EXCESS IN BONE AND MUSCLE.
GLUCOCORTICOID EXCESS IN BONE AND MUSCLE.
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DOI：
10.1007/s12018-018-9242-3
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发表时间：
2018-03
影响因子：
1.8
通讯作者：
Bellido T
中科院分区：
文献类型：
--
作者：
Sato AY;Peacock M;Bellido T
糖皮质激素（GC）由肾上腺产生和释放，调节广泛组织中的许多生理过程。由于其深刻的免疫抑制和抗炎作用，GC被广泛用于治疗免疫和炎症状况，器官移植的管理，并作为癌症化疗方案的组成部分。然而，病理性内源性升高和长期使用外源性GC均与严重的不良反应相关。特别是，过量的GC对肌肉骨骼系统具有破坏性影响。GC增加骨吸收，减少骨形成，导致骨丢失、微结构恶化和骨折。GC还诱导肌肉质量和力量的损失，导致福尔斯的发生率增加。对骨骼和肌肉的综合影响是GC骨折风险增加的原因。本文综述了近20年来GC在骨骼和肌肉中的作用机制，以及如何干预GC在这些组织中的损伤作用，以期开发更有效的治疗策略。
Glucocorticoids (GC), produced and released by the adrenal glands, regulate numerous physiological processes in a wide range of tissues. Because of their profound immunosuppressive and anti-inflammatory actions, GC are extensively used for the treatment of immune and inflammatory conditions, the management of organ transplantation, and as a component of chemotherapy regimens for cancers. However, both pathologic endogenous elevation and long-term use of exogenous GC are associated with severe adverse effects. In particular, excess GC has devastating effects on the musculoskeletal system. GC increase bone resorption and decrease formation leading to bone loss, microarchitectural deterioration and fracture. GC also induce loss of muscle mass and strength leading to an increased incidence of falls. The combined effects on bone and muscle account for the increased fracture risk with GC. This review summarizes the advance in knowledge in the last two decades about the mechanisms of action of GC in bone and muscle and the attempts to interfere with the damaging actions of GC in these tissues with the goal of developing more effective therapeutic strategies.